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TUBERCULOSIS OF SPINE
AND BONE
MR. KUSH JOSHI
DEFINATION
POTT’S SPINE IS ALSO KNOWN AS
TUBERCULOSIS IN SPINAL CORD AND SPINE (
INTERVERTEBRAL JOINTS), IT OCCURS WHEN THE
MYCOBACTERIUM TUBERCULOSIS ARE REACHED IN
SPINAL CORD AND AFFECT SPINAL CORD.
IN POTT’S DISEASE, BONE IS THE MOST
COMMON SITE OF TUBERCULOSIS.
ETIOLOGICAL FACTORS
• CAUSATIVE ORGANISMS:- MYCOBACTERIUM
TUBERCULOSIS
• SPREAD:- LYMPHATIC AND HEMATOGENOUS (
THROUGH BLOOD )
CLINICAL MANIFESTATIONS
• BACK PAIN
• RESTRICTED SPINAL MOVEMENT
• FEVER
• NIGHT SWEATS
• ANOREXIA AND WEIGHT LOSS
• FATIGUE AND WEAKNESS
• SPINAL DEFORMITY ( KYPHOSIS)
• MUSCLE WASTING ( THINNING)
• PARAVERTEBRAL SWELLING MAY BE SEEN
• NUMBNESS, PARESTHESIA, OR MUSCLE WEAKNESS OF
THE LEGS
• BONE NECROSIS
• PATIENT TENDS TO ASSUME A PROTECTIVE UPRIGHT,
STIFF POSITION
• COMPRESSIVE MYELOPATHY ( COMPRESSION OF SPINAL
CORD)
• OSTEOMYELITIS
DIAGNOSTIC EVALUATION
• HISTORY COLLECTION AND PHYSICAL EXAMINATION
• COMPLETE BLOOD COUNT
• SPINAL X-RAY
• CSF TEST( TO FIND OUT MYCOBACTERIUM
TUBERCULOSIS)
• TUBERCULIN TEST( MANTAUX TEST)
• CT SCAN AND MRI SCAN
MANAGEMENT
• ANTITUBERCULIN DRUGS
• IMMOBILIZATION OF AFFECTED JOINT
• BED REST
• ADVICE TO TAKE NUTRITIOUS, HIGH PROTEIN DIET
• DRAINAGE OF ABSCESS IF PRESENT
• PHYSIOTHERAPY PROVIDED TO PATIENT
SURGICAL MANAGEMENT
• DECOMPRESSION SURGERY ( LAMINECTOMY) OPENS THE
BONY CANAL THROUGH WHICH THE SPINAL CORD AND
NERVES PASS, CREATING MORE SPACE FOR THEM TO
MOVE FREELY. NARROWING/ STENOSIS OF THE SPINAL
AND NERVE ROOT CANALS CAN CAUSE CHRONIC PAIN,
NUMBNESS AND MUSCLE WEAKNESS IN ARMS OR LEG.
THANK YOU…

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  • 1. TUBERCULOSIS OF SPINE AND BONE MR. KUSH JOSHI
  • 2. DEFINATION POTT’S SPINE IS ALSO KNOWN AS TUBERCULOSIS IN SPINAL CORD AND SPINE ( INTERVERTEBRAL JOINTS), IT OCCURS WHEN THE MYCOBACTERIUM TUBERCULOSIS ARE REACHED IN SPINAL CORD AND AFFECT SPINAL CORD. IN POTT’S DISEASE, BONE IS THE MOST COMMON SITE OF TUBERCULOSIS.
  • 3. ETIOLOGICAL FACTORS • CAUSATIVE ORGANISMS:- MYCOBACTERIUM TUBERCULOSIS • SPREAD:- LYMPHATIC AND HEMATOGENOUS ( THROUGH BLOOD )
  • 4. CLINICAL MANIFESTATIONS • BACK PAIN • RESTRICTED SPINAL MOVEMENT • FEVER • NIGHT SWEATS • ANOREXIA AND WEIGHT LOSS • FATIGUE AND WEAKNESS • SPINAL DEFORMITY ( KYPHOSIS)
  • 5. • MUSCLE WASTING ( THINNING) • PARAVERTEBRAL SWELLING MAY BE SEEN • NUMBNESS, PARESTHESIA, OR MUSCLE WEAKNESS OF THE LEGS • BONE NECROSIS • PATIENT TENDS TO ASSUME A PROTECTIVE UPRIGHT, STIFF POSITION • COMPRESSIVE MYELOPATHY ( COMPRESSION OF SPINAL CORD) • OSTEOMYELITIS
  • 6. DIAGNOSTIC EVALUATION • HISTORY COLLECTION AND PHYSICAL EXAMINATION • COMPLETE BLOOD COUNT • SPINAL X-RAY • CSF TEST( TO FIND OUT MYCOBACTERIUM TUBERCULOSIS) • TUBERCULIN TEST( MANTAUX TEST) • CT SCAN AND MRI SCAN
  • 8. • ANTITUBERCULIN DRUGS • IMMOBILIZATION OF AFFECTED JOINT • BED REST • ADVICE TO TAKE NUTRITIOUS, HIGH PROTEIN DIET • DRAINAGE OF ABSCESS IF PRESENT • PHYSIOTHERAPY PROVIDED TO PATIENT
  • 9. SURGICAL MANAGEMENT • DECOMPRESSION SURGERY ( LAMINECTOMY) OPENS THE BONY CANAL THROUGH WHICH THE SPINAL CORD AND NERVES PASS, CREATING MORE SPACE FOR THEM TO MOVE FREELY. NARROWING/ STENOSIS OF THE SPINAL AND NERVE ROOT CANALS CAN CAUSE CHRONIC PAIN, NUMBNESS AND MUSCLE WEAKNESS IN ARMS OR LEG.
  • 10.